各種低分子ヘパリンの出血時間と凝固能に関する検討　　低分子ヘパリンはどれも同じか？

DOI 被引用文献3件 参考文献10件

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タイトル別名
  • Comparison study between various low molecular weight heparins (LMWHs) in bleeding time and anticoagulant properties. Are all LMWHs the sama?
  • Are all LMWHs the sama?
  • 低分子ヘパリンはどれも同じか?

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We compared three low molecular weight heparins (LMWHs), dalteparin sodium (Fragmin; FR), parnaparin sodium (Lowhepa; LH) and reviparin sodium (Lowmorin; LM), which have various molecular weights influencing their effects on hemorrhage and anticoagulant properties, and evaluated the clinical usefulness of these agents. Seven hemodialyzed patients with hemorrhagic lesions or bleeding tendency being treated in our hospital were enrolled in this study (5 males and 2 females). Their mean age was 71.4±11.5. Each patient received one of the LMWHs for a week, an initial bolus dose of 15-20IU/kg followed by an infusion dose of 7.5-10IU/kg/hr. At the final hemodialysis of the week, we evaluated the usefulness of the LMWH measuring the plasma anti-Xa activity and anti-IIa activity, bleeding time, hemostatic time after withdrawal of the needle, and degree of residual blood in the dialyzer and coagulated blood in the air-trap chambers. The other two LMWHs were evaluated in the same manner. Three weeks after beginning this trial, we compared the usefulness of the three LMWHs by the crossover method.<br>1. In anti-Xa/anti-IIa activity ratio at the end of dialysis, the value at administration of LM was significantly higher than that at administration of LH (p<0.001) and FR (p<0.01). 2. Regarding bleeding time, the value at administration of LM was significantly shorter than that at administration of LH (p<0.05). 3. In terms of the interaction between anti-Xa/anti-IIa activity ratio at the end of dialysis and bleeding time, significantly (p<0.05) inverse relationship was confirmed by correlation coefficient of r=-0.54.<br>From the above results, it was suggested that reviparin sodium (Lowmorin; LM) is a useful LMWH for the treatment of dialysis patients with hemorrhagic lesion or bleeding tendency. It was also concluded that since there are various kind of LMWHs, the anticoagulant agent should be carefully chosen for dialysis therapy with a precise understanding of the pharmacological properties.

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